Gait Variability in Community Dwelling Adults With Alzheimer Disease

Abstract

Studies have shown that measures of gait variability are associated with falling in older adults. However, few studies have measured gait variability in people with Alzheimer disease, despite the high incidence of falls in Alzheimer disease. The purpose of this study was to compare gait variability of community-dwelling older adults with Alzheimer disease and control subjects at various walking speeds. Ten subjects with mild-moderate Alzheimer disease and ten matched control subjects underwent gait analysis using an electronic walkway. Participants were required to walk at self-selected slow, preferred, and fast speeds. Stride length and step width variability were determined using the coefficient of variation. Results showed that stride length variability was significantly greater in the Alzheimer disease group compared with the control group at all speeds. In both groups, increases in walking speed were significantly correlated with decreases in stride length variability. Step width variability was significantly reduced in the Alzheimer disease group compared with the control group at slow speed only. In conclusion, there is an increase in stride length variability in Alzheimer disease at all walking speeds that may contribute to the increased incidence of falls in Alzheimer disease.

The Relationship between Executive Function and Falls and Gait Abnormalities in Older Adults: A Systematic Review

“…Increased variability of stride length and swing time have been shown to best predict falls, and to be the only predictors of injurious falls, in an older population [18]. Increased stride length variability has been observed in subjects with Alzheimer's disease compared to controls [49]. Executive function has been associated with measures of gait variability in cross-section, but longitudinal analyses examining executive function as a predictor of gait variability and a potential mediator of high fall rates in people with dementia have not been completed.…”

Timing Variability during Gait Initiation Is Increased in People with Alzheimer’s Disease Compared to Controls

“…The Mini Mental State Examination (MMSE) was used to evaluate cognitive dysfunction [28] . This test has a highest possible score of 30 with severity of dementia graded as questionable (MMSE range [26][27][28][29], mild (MMSE range [21][22][23][24][25], moderate (MMSE range [11][12][13][14][15][16][17][18][19][20] and severe (MMSE range 0-10) [29] .…”

“…A number of studies have found that gait variability is increased during constant speed walking in people with AD [9][10][11][12] ; however, initiation of gait may provide a greater challenge to stability [13] and so can be used to investigate mechanisms underlying the control of balance [14] . Many falls are reported in older people when they start and stop walking or change direction [15] and when they walk short distances in which initiation and termination phases are a large proportion of the walk [16] .…”

Gait Variability Is Associated with Subclinical Brain Vascular Abnormalities in High-Functioning Older Adults

“…Gait parameters become increasingly variable with increasing age [5] or when walking under challenging conditions [6] or when performing dual tasks [7,8] . Increased step length variability and asymmetry in timing also increase in individuals with Alzheimer's disease [9] or known basal ganglia disease, such as Parkinson's disease and Huntington's disease [10,11] . Figure 1 illustrates possible mechanisms underlying increased gait variability.…”